In this study, the computed tomography scans of 100 patients with chronic hyperplastic rhinosinusitis were reviewed to establish a clinical staging system. Fourteen percent of the patients were classified as Stage I (single-focus disease); 36% as Stage II (multifocal disease responsive to conservative therapy); 32% as Stage III (diffuse disease partially responsive to medication); and 16% as Stage IV (diffuse disease associated with bony changes and poorly responsive to conservative treatment). The incidence of recurrent or persistent disease ranged from 13% for Stage II to 30% for Stage IV. Stage I and III patients had 13% and 18% recurrence rates, respectively. Computed tomography staging is shown to be useful in outlining operative strategies and is a reliable prognosticator of the disease process.

In this retrospective study, 34 patients with recurrent hyperplastic rhinosinusitis who subsequently underwent further surgical intervention were evaluated with computed tomography scans in order to assess the role of computed tomography in revision sinus surgery. Fourteen of these patients had originally undergone sphenoethmoidectomies, 8 had endoscopic sinus surgeries, 6 had Caldwell-Luc operations, and 6 had intranasal antrostomies. Computed tomography scan was instrumental in correctly identifying the site and reasons for failure and assisted in localizing further surgical intervention to the appropriate sites in 30 patients. The indications for computed tomography and revision surgery are discussed and defined.